Participate in this interactive Computer Simulation Assessment Tool (CSAT) to challenge your own clinical decision-making and receive meaningful feedback that enhances your clinical skillset for patients with Major Depressive Disorder (MDD).

During this activity, view a simulated clinical encounter with a patient and provide your assessment as to any presence of fatigue and related symptoms, as well as your recommendation for an appropriate pharmacologic treatment strategy. Choose from a menu of treatment and discussion options that mirror the choices you typically face in an actual clinical encounter, and receive feedback on your performance relative to your peers.

Evidence shows that fatigue is under-recognized and under-treated, and is among the most persistent and refractory symptoms in patients suffering from MDD. Since patients with MDD often present across the entire spectrum of practice settings, it's critical for all professionals to remain proficient in a broad toolkit of effective interventions -- this includes psychiatrists, primary care and family practice physicians, nursing professionals, physician assistants, psychologists, and other mental health clinicians who provide care for patients.

To download the CPFQ Rating Scale, visit:

Learning Objectives

At the end of this educational activity, participants should be able to:

  • Recognize the limitations of current antidepressant therapy, and monitor patients for persisting, residual symptoms.
  • Identify fatigue in depressed patients and assess fatigue symptoms using clinical interviews and formal screening tools.
  • Employ appropriate pharmacologic treatments to treat or prevent fatigue in patients with depression.

Target Audience

Psychiatrists, psychologists, primary care/family physicians, nurses and nurse practitioners, and allied healthcare professionals.


  • Director, Division of Education
    Deputy Medical Director
    American Psychiatric Association
    Assistant Professor of Psychiatry, Harvard Medical School
    Consultant, Department of Psychiatry, Massachusetts General Hospital
  • Director of Research, Depression Clinical and Research Program
    Massachusetts General Hospital
    Associate Professor of Psychiatry
    Harvard Medical School

CME Information

Release Date: November 14, 2014
Latest Review:Michael Hirsch, MD on November 13, 2015
Expiration Date: November 14, 2016

To receive credit for this activity, view the presentation and complete the post-test and activity evaluation.

Accreditation Statement

This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of McLean Hospital and the Massachusetts General Hospital Psychiatry Academy. McLean Hospital is accredited by the ACCME to provide continuing medical education for physicians.

McLean Hospital designates this enduring material for a maximum of 1 AMA PRA Category 1 CreditTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Credit Designation

Psychologists: The Massachusetts General Hospital Department of Psychiatry is approved by the American Psychological Association to sponsor continuing education for psychologists. The Massachusetts General Hospital Department of Psychiatry maintains responsibility for this program and its content. This offering meets the criteria for 1 Continuing Education (CE) credit for psychologists.

Nurses: This program meets the requirements of the Massachusetts Board of Registration in Nursing (244 CMR 5.00) for 1 contact hour of nursing continuing education credit.

Policy on Faculty and Provider Disclosure

It is the policy of McLean Hospital that faculty and providers disclose real or apparent conflicts of interest relating to the topics of this educational activity. McLean Hospital has established policies in place that identify and resolve all conflicts of interest prior to this educational activity.

Planner Disclosures

The following planners and/or their spouse/partner have reported no relevant financial relationship with a commercial interest:

Tristan Gorrindo, MD, Reviewer
Michael Hirsch, MD, Reviewer
Jane Pimental, MPH

Speaker Disclosures

The following speakers and/or their spouse/partner have reported a relevant financial relationship with a commercial interest:

David Mischoulon, MD, PhD

Research support: TheBowman Family Foundation, Bristol-Myers Squibb Co., Cederroth, FisherWallace, Ganeden, Lichtwer Pharma, Nordic Naturals, Laxdale (Amarin), Methylation Sciences, Inc. (MSI), SwissMedica
Honoraria for consulting, speaking, and writing: Pamlab, Bristol-Myers Squibb Co., Nordic Naturals, Virbac, Pfizer, Reed Medical Education, and the Massachusetts General Hospital Psychiatry Academy
Royalties:Back Bay Scientific for PMS Escape; Lippincott Williams & Wilkins for published book "Natural Medications for Psychiatric Disorders: Considering the Alternatives"

Educational Support:

This program has received support in the form of educational grants from the following companies:

  • Lilly USA, LLC
  • Takeda Pharmaceutical International, Inc.
  • Lundbeck

Hardware/Software Specifications

This internet-based CME activity is best experienced using Internet Explorer 8+, Mozilla Firefox 3+, Safari 4+. This Web site requires that JavaScript and session cookies be enabled. Certain activities may require additional software to view multimedia, presentation, or printable versions of the content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Adobe Acrobat, Microsoft PowerPoint, and Windows Media Player.

Optimal System Configuration

Flash Player: Adobe Flash Player 10.1+
Browser: Firefox 3+, Internet Explorer 8.0+, Safari 4.0+, or Google Chrome 7.0+
Operating System: Windows XP+ or Mac OS X 10.4+
Internet Connection: 1 Mbps or higher

Minimum Requirements

Windows PC:500-MHz Pentium II; Windows XP or higher; 128 MB RAM; Video Card at least 64MB of video memory; Sound Card at least 16-bit; Macromedia Flash Player 10 or higher, audio playback with speakers for programs with video content; Firefox 1.1+, Internet Explorer 7.0+, Safari 1.0+, Google Chrome, or Opera
Macintosh:Mac OS X 10.3 or higher with latest updates installed; 1.83MHz Intel Core Duo or faster; RAM: 128MB or more; Video Card: at least 64MB of video memory; Sound Card: at least 16-bit

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This program has received support in the form of educational grants from the following companies: